BabyWhispererForums.com
EAT => Breast Feeding => FAQ's - Frequently Asked Questions & Related Information - Breast => Topic started by: Samuel's mum on August 26, 2006, 11:49:17 am
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Lactation consultants and breastfeeding specialists are not always in agreement about whether sore nipples are a normal part of the early weeks of breastfeeding. Some experts feel strongly that breastfeeding should never hurt and if it does further advice should be sought. Others feel some tenderness is normal (especially for mothers who have very sensitive skin - those with red hair and a paler complexion are especially prone apparently.)
However it seems a few things are agreed on:
1. If the tenderness is painful to the point you are dreading the next feed or continuing during the feed - you should certainly get help. A poor latch is a very common cause of nipple soreness. e.g the baby not opening his mouth widely enough and instead feeding too much on the nipple. In a correct latch the nipple should be so deep inside the baby's mouth that it bypasses the baby's hard palate and is no longer rubbing painfully. This page has several videos that demonstrate a good latch:
http://www.breastfeedinginc.ca/content.php?pagename=videos
However if you do suspect latching is the problem it is vital you get help from a qualified professional. If the baby is not latching on properly or has a poor position (perhaps nipples continue to be painful, baby doesn't have a wide gape of breast, baby's head is turned to feed, baby makes a clicking sound while feeding) then the baby will not be feeding properly. This can mean the baby does not get enough milk but also that your milk supply will not be stimulated effectively and you could soon run into supply problems. Speaking to a professional does not need to be expensive - there are free helplines available with numbers on the FAQ board ("In real life" help, Useful websites, helplines). It is also possible to speak to a La Leche League leader or go to a breastfeeding group (hospitals are great contacts to find these) or 'baby cafe' (in the UK) where a breastfeeding expert should be in attendance. Ideally you would want to have a face-to-face consultation. You could also ask your doctor about what resources are available.
2. It's also agreed how best to look after breastfeeding nipples. Nipples have their own secretions and oils to protect them and washing nipples with soap is a bad idea. All you need is some plain water and a gentle towel dry. It's also amazing how many utterly useless nipple creams are on the market. The La Leche League recommend a cream called Lansinoh which is pure medical grade lanolin. (comes in a purple tube, costs about £9 in Boots in the UK but available worldwide.) Only a tiny amount goes a long way and it doesn't have to be removed before a feed. However if you are finding yourself relying on a cream to get you through the day then, again, it is worth remembering that a poor latch is a major cause of nipple pain and there are other causes too that you should get ruled out by an expert. Rubbing on a few drops of your own milk is also recommended.
3. Nipple skin is also very sensitive to allergic reactions so if you find any itchiness think about whether you might have been exposed to something like new washing powder. Nipple soreness can also be thrush related so have a look at the Thrush FAQ (Thrush) to see if you recognise any other symptoms such a deeper pain between or after feeds/ red shininess/ signs of thrush in your baby.
4. If your nipples begin to have small cracks this can make you more vulnerable to other infections. Lansinoh can help you create a moist healing environment which is the recommended way to go. There is some good advice about how to help heal cracked nipples here:
http://kellymom.com/bf/concerns/mother/nipplehealing/
(However this is assuming you have already got some advice about your latch as nothing will heal properly if a latching problem continues.)
So from what I've read it seems:
Slight tenderness is not uncommon for the first few days/ couple of weeks but do check you don't have any latching problems in the meantime and the baby has a good mouthful of breast.
Avoid soap and unnecessary creams but pure grade lanolin can be a useful tool.
Pain that does not go away once the feed is established or continues beyond the first couple of weeks or makes you feel really sad should be checked out by someone trained.
Nipple pain that comes on suddenly with no previous history (perhaps you've already been feeding a few weeks/months successfully) could be related to another infection such as thrush.
There's more to read about sore nipples here:
http://www.lalecheleague.org/FAQ/sore.html
http://www.lalecheleague.org/FAQ/heal.html
In my experience I had sore nipples for the first 10 days or so (and some small cracks). I ruled out latching problems and used pure grade lanolin. I varied feeding positions to give some relief and within a few days I was completely painfree. In the end, yes it was a bit sore but it was certainly certainly worth it. Not everyone even has my amount of soreness.
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a couple points to add:
Pay attention that if you have to break your baby's latch you don’t just pull the baby away but break the vacuum by gently pushing your finger into the corner of their mouth.
a few natural treatments for cracked and sore nipples:
If you use breast pads try and get some made from natural materials – silk is best, not only as it is so smooth but also for its anti-bacterial properties (available on line from for example www.spiritofnature.co.uk )
Cracks can be healed by applying undiluted Calendula essence or Ratania (Krameria) tincture. Dip a cotton bud in the tincture and apply carefully before and after feeding.
Exposure to air, light and sun is one of the very most effective ways of healing sore nipples.
information taken from Die Hebammen Sprechstunde by Ingeborg Stadelmann
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Emma posted on a thread today and it was brought to my attention by a very wise BWer that this info would be useful in this FAQ page :) - so I've coppied Emma's reply:
One thing I would add to that sore nipples FAQ is that I am finding increasingly that sore cracked nipples can be to do with positioning as much as latch. (I am seeing new mums as my work as a bf counsellor in the UK). The latch may be technically great with a nice big mouthful but the baby moves during the feed due to a positioning issue which then brings the baby out of the optimum position. Perhaps the bf pillow/ cushion sags during the feed, mum's arms tire, mum leans back once baby is on, mum 'offers' breast rather than bringing baby to breast and hunches forward.
Clues that it is a positioning issue: - your arms, hands, neck, back ache sometimes; if you are using cradle hold it is your 'weaker' side (i.e. left if you are right handed) that is more cracked; you have cracks in the same position on both sides.
The nipple itself can be a map which tells you the issue. A central crack or nipple that comes off squashed and compressed like a used lipstick is not going far enough into baby's mouth so that could be latch or baby not being tummy-to-tummy. A crack at the bottom of the nipple may be baby too high or not around towards the armpit enough. A high crack may be baby too low or slipping during a feed.
With latch things can change after only a few days. Back home you will be sitting differently on different furniture. You need someone to come and watch you feed at home now. Hospital consultations were a while ago again and may have happened before milk fully transitioned and feeding style was different.
If you are considering not bfing then something is definitely not right. An LC consulation now will be a LOT cheaper than moving to formula let alone all the health considerations for your baby. The ABA may be able to help for free too.
http://www.breastfeeding.asn.au/products/counselling.asp
If your cracks are reopening then this is more than tenderness. There is something incorrect about your positioning which is causing a 'pull' to reopen them. It may just be a 5 minute conversation that completely solves your problem. It may just be 'one tip' that changes everything and has a life-time effect on your baby's health.
Expressing may rest the breast but it won't solve the problem if you then return to a problem latch. You are also not stimulating your supply as it quite needs at this age. But crucially a bottle at this age really could be making things a lot worse. You are giving lessons in poor attachment every time you use a bottle. If you want to feed a young baby the quantities are so small that syringing a small amount at a time into the corner of their mouth is a better alternative. All bf folks will tell you to hold off on dummies/ pacis and bottles until your latch is pain-free.
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Adding more info about tongue-tie here via this thread http://babywhispererforums.com/index.php?topic=129876.0